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Detection of infusate leakage in the brain using real-time imaging of convection-enhanced delivery.

Publication ,  Journal Article
Varenika, V; Dickinson, P; Bringas, J; LeCouteur, R; Higgins, R; Park, J; Fiandaca, M; Berger, M; Sampson, J; Bankiewicz, K
Published in: J Neurosurg
November 2008

OBJECT: The authors have shown that convection-enhanced delivery (CED) of gadoteridol-loaded liposomes (GDLs) into different regions of normal monkey brain results in predictable, widespread distribution of this tracking agent as detected by real-time MR imaging. They also have found that this tracking technique allows monitoring of the distribution of similar nanosized agents such as therapeutic liposomes and viral vectors. A limitation of this procedure is the unexpected leakage of liposomes out of targeted parenchyma or malignancies into sulci and ventricles. The aim of the present study was to evaluate the efficacy of CED after the onset of these types of leakage. METHODS: The authors documented this phenomenon in a study of 5 nonhuman primates and 7 canines, comprising 54 CED infusion sessions. Approximately 20% of these infusions resulted in leakage into cerebral ventricles or sulci. All of the infusions and leakage events were monitored with real-time MR imaging. The authors created volume-distributed versus volume-infused graphs for each infusion session. These graphs revealed the rate of distribution of GDL over the course of each infusion and allowed the authors to evaluate the progress of CED before and after leakage. RESULTS: The distribution of therapeutics within the target structure ceased to increase or resulted in significant attenuation after the onset of leakage. CONCLUSIONS: An analysis of the cases in this study revealed that leakage undermines the efficacy of CED. These findings reiterate the importance of real-time MR imaging visualization during CED to ensure an accurate, robust distribution of therapeutic agents.

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Published In

J Neurosurg

DOI

ISSN

0022-3085

Publication Date

November 2008

Volume

109

Issue

5

Start / End Page

874 / 880

Location

United States

Related Subject Headings

  • Organometallic Compounds
  • Neurology & Neurosurgery
  • Models, Animal
  • Male
  • Magnetic Resonance Imaging
  • Macaca fascicularis
  • Liposomes
  • Heterocyclic Compounds
  • Gadolinium
  • Drug Delivery Systems
 

Citation

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Varenika, V., Dickinson, P., Bringas, J., LeCouteur, R., Higgins, R., Park, J., … Bankiewicz, K. (2008). Detection of infusate leakage in the brain using real-time imaging of convection-enhanced delivery. J Neurosurg, 109(5), 874–880. https://doi.org/10.3171/JNS/2008/109/11/0874
Varenika, Vanja, Peter Dickinson, John Bringas, Richard LeCouteur, Robert Higgins, John Park, Massimo Fiandaca, Mitchel Berger, John Sampson, and Krystof Bankiewicz. “Detection of infusate leakage in the brain using real-time imaging of convection-enhanced delivery.J Neurosurg 109, no. 5 (November 2008): 874–80. https://doi.org/10.3171/JNS/2008/109/11/0874.
Varenika V, Dickinson P, Bringas J, LeCouteur R, Higgins R, Park J, et al. Detection of infusate leakage in the brain using real-time imaging of convection-enhanced delivery. J Neurosurg. 2008 Nov;109(5):874–80.
Varenika, Vanja, et al. “Detection of infusate leakage in the brain using real-time imaging of convection-enhanced delivery.J Neurosurg, vol. 109, no. 5, Nov. 2008, pp. 874–80. Pubmed, doi:10.3171/JNS/2008/109/11/0874.
Varenika V, Dickinson P, Bringas J, LeCouteur R, Higgins R, Park J, Fiandaca M, Berger M, Sampson J, Bankiewicz K. Detection of infusate leakage in the brain using real-time imaging of convection-enhanced delivery. J Neurosurg. 2008 Nov;109(5):874–880.

Published In

J Neurosurg

DOI

ISSN

0022-3085

Publication Date

November 2008

Volume

109

Issue

5

Start / End Page

874 / 880

Location

United States

Related Subject Headings

  • Organometallic Compounds
  • Neurology & Neurosurgery
  • Models, Animal
  • Male
  • Magnetic Resonance Imaging
  • Macaca fascicularis
  • Liposomes
  • Heterocyclic Compounds
  • Gadolinium
  • Drug Delivery Systems